- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,268.16 / $11,904.80 / $31,630.00
| Facility | | $9,268.16 | $11,904.80 | $31,630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,587.90 / $11,367.12 / $19,256.15
| Facility | | $7,587.90 | $11,367.12 | $19,256.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,251.06 / $12,684.84 / $18,482.00
| Facility | | $10,251.06 | $12,684.84 | $18,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,372.50 / $12,734.80 / $33,930.10
| Facility | | $6,372.50 | $12,734.80 | $33,930.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,372.50 / $12,158.73 / $17,088.50
| Facility | | $6,372.50 | $12,158.73 | $17,088.50 |